Relationship Between Fragmented QRS Complex and Long-Term Cardiovascular Outcome in Patients with Essential Hypertension.

Background: In patients with essential hypertension, fragmented QRS has been asso- ciated with many remodeling components that might lead to adverse cardiovascular effects. This study aimed to evaluate the relationship between fragmented QRS and adverse events and its potential long-term prognostic value.

Methods: The patients with essential hypertension were divided into two groups accord- ing to the presence of fragmented QRS: fragmented QRS (+) and fragmented QRS (-). During long-term follow-up, the relationship of fragmented QRS to coronary artery dis- ease, congestive heart failure, stroke, cardiovascular death, all-cause death, and majoradverse cardiovascular and cerebrovascular events was evaluated.

Results: The study group included 542 patients with essential hypertension. Fragmented QRS on ECG was observed in 224 (41.3%) patients. Considering the incidence rates at the end of 5.6 ± 1.3 years' follow-up, the total incidence rate of major adverse cardiovascular and cerebrovascular events (P < .001), coronary artery disease (P < .001), and congestive heart failure (P < .001) were higher in patients with fragmented QRS. No significant dif- ference was observed between the two groups in terms of stroke (P = .734), cardiovas- cular death (P=1), and all-cause death (P=.574). As a result of multiple cox regression analysis, fragmented QRS (P = .005) was identified as an independent predictor for major adverse cardiovascular and cerebrovascular events development.

Conclusion: In patients with hypertension, the presence of fragmented QRS was found as an independent predictor for major adverse cardiovascular and cerebrovascular events development.